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Does TMJ Really Require Crowns on Every Tooth?

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I mentioned to my dentist that I wanted whiter teeth. I thought we’d talk about teeth whitening. Instead, he’s said there is something wrong with my bite and I need to have all my teeth crowned to repair it. This really surprised me because I had braces when I was younger and my teeth/ bite have never bothered me.  He thinks I have TMJ and it’s the only option. I’m thinking of getting a second opinion.

Chelsea – South Dakota

Chelsea,

Whoa!  Did you even mention bite problems? Normally, TMJ would have some symptoms such has your jaw locking, popping, migraines, jaw pain, etc.  If you’ve had none of these symptoms, TMJ would be a surprising diagnosis.

Even if you had TMJ, a full mouth reconstruction is a last resort procedure, especially if your teeth are otherwise healthy. Why grind down healthy tooth structure? There are many other procedural options.

If I were in your place, I’d definitely get a second opinion.  For teeth whitening, you wouldn’t need crowns either, unless you have a tooth that is already crowned. Even then, you would do traditional teeth whitening on all of your other teeth and just get the one crown replaced.

His recommendation is dubious to me. Especially if you’ve given me all the information.

This blog is brought to you by Dr. Theodore Hadgis.

 

Can A Crown Make Make TMJ Worse

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I have TMJ. My dentist said it’s because I don’t wear a nightguard and I grind my teeth. It was annoying, but livable. Then I had to get a dental crown.  Something seemed off on how it fit because I always his that “tooth” first. It caused a lot of pain and now I feel like my jaw pains has gotten worse too. Can that be from the crown?

Amanda E. – Boston

Amanda,

Yes, it is likely that the crown is aggrevating the problem.  In fact, an improper bite can actually cause TMJ. It takes a good deal of training to understand the anatomy and mechanics of a proper bite.

Not all dentists have the training needed to do that properly. Often those dentists just adjust and adjust the crown until the patient, out of weariness of returning, says it’s fine and just deals with it. Other times they ground down the crown until it falls beneath the rest of the bite. Neither of these are a good solution.

My suggestion is to go to a dentist familiar with TMJ and neuromuscular dentistry and have him look at your crown. I would also highly suggest you get a mouthguard. Teeth grinding can cause severe problems later on in your bite.

This blog is brought to you by Dr. Theodore Hadgis.

Is there such a thing as a TMJ specialist?

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My dentist suggests that I have TMJ. I did some research and he is likely right. There seem to be a lot of dentists who advertise as TMJ Specialists. My dentist says there is no such thing as a TMJ specialist. Which is it?

Tina S. – Bryant, AR

Tina,

Good question. In a way, both are right. There isn’t a recognized specialty in TMJ. Any general dentist can, with the right post-graduate training, treat TMJ.

Generally, if someone says they’re a TMJ specialist, what they mean is they have taken the time to get a significant amount of TMJ training.

If you’re concerned about your dentist’s training, just ask him. Here are some good places for him to have received training in TMJ:

  • The Las Vegas Institute of Advanced Dental Studies (LVI)
  • The Kois Center
  • The Dawson Academy
  • The TMJ Institute of America

If your dentist names a place other than this, feel free to ask about it.

This blog is brought to you by Dr. Theodore Hadgis.

Could bad dental work cause TMJ problems?

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I’m in the middle of a battle with my ex-dentist. I needed two crowns done, but he did a terrible job. In fact, the crowns are “higher” than all my other teeth and hit the opposite arch before any other teeth. At first it was just annoying and mildly painful, but now I’m having pretty serious jaw and head pain. Could his incompetent work be causing me to develop TMJ?

Tatiana R. – LIttle Rock, AR

Tatiana,

Without examing you, I couldn’t give a definitive answer. However, poorly fitting crowns can be an impetus to TMJ. Your teeth need to come together properly.

I’m assuming you’ve gotten a second opinion from another dentist. Sometimes pressure from one’s peers works wonders in getting an errant dentist to cooperate.

Don’t put off getting this taken care of. Your second dentist can always replace the crowns while working with you to get your dentist to refund your money from the original procedure.

Often, the sooner you treat the cause of TMJ, the simpler the solution (and lower the cost).

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.

Can pregnancy cause TMJ?

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I’ve never had any problems with TMJ, until I became pregnant. Now all of a sudden my dentist says I’m afflicted with TMJ and wants me to wear some kind of mouth piece that looks hideous. Can pregnancy cause TMJ?

Meagan H. – Boston

Meagan,

There have been no studies linking pregnancy as a cause. However, pregnancy can be stressful. Between the changes occuring in your body, worrying about preparation for baby’s arrival, the expense of OB’s and hospitals, etc… it is possible that you have been grinding or clenching your teeth without realizing it.  This could lead to TMJ.

If your dentist is recommending a mouthguard, then it is likely he has seen evidence of this in your bite.  You may have noticed having more headaches than usual as a result as well.

I would get the mouthguard.  You’ll likely find improvement in how you feel in a short amount of time.

Congratulations on your upcoming bundle of joy.  There is nothing as wonderful as a new baby in a home.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Do I really need a full mouth reconstruction?

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I went to the dentist because of jaw pain and headaches, thinking they might be connected. He said they were and it was a good thing I came in, because it is TMJ and I need a full mouth reconstruction.  Really?  That is thousands of dollars.  Should I get a second opinion or is this the standard treatment?

Melissa A. – Utah

Melissa,

This is not the standard TMJ treatment. In fact, it is only used in extreme cases. It certainly wouldn’t be the first treatment jumped to without their being extenuating circumstances. Take a look at Dr. Hadgis’ TMJ Treatment page to get an idea of what you should expect.   In your case, I would definitely get a second opinion.

Make sure whomever you go to for the second opinion has a lot of training in neuromuscular dentistry.  For instance, Dr. Hadgis has done extensive studies with the Las Vegas Institute for Advanced Dental Studies, including courses on full-mouth reconstruction.

It is an extremely advanced procedure and if not done well, then you’ll end up in a much worse situation than you’re currently in.

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.

Treatment for TMJ

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I suspect I have TMJ. I heard the treatment for that is surgery.  Are there any other options?

Alicia H. – Penn.

Alicia,

There is a whole range of treatments for TMJ that do not involve surgery. One of the most common is an orthotic; a mouthpiece worn on the upper or lower teeth, This not only relieves pressure on the joints, but also places the jaw in its proper position.

There are also medications that can be prescribed to relax muscles, reduce pain and inflammation. Another option is “trigger point” injections; injections used to alleviate muscle and tendon inflammation and soreness. Sometimes, it is a combination of these treatments.

Surgery should only be considered when all  other treatment options were unsuccessful. Generally, it is used to treat patients with limited jaw opening (closed lock), where conservative therapy has failed, or if there is clear joint damage.

TMJ disorders can be successfully treated, but make sure you go to a qualified TMJ dentist.  They should have had extensive post-graduate training in neuromuscular dentistry.

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.

Store Bought TMJ mouthguard

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I have TMJ. I’ve heard that you can a store bought mouthpiece much cheaper than the one at the dentist’s office.  Do they work?

Sarah B. – Oklahoma

Sarah,

If your need a mouthguard, the ones in the drug store will be better than nothing at all, but they do not work nearly as well as the one you get with your dentist.

The store bought one will give you three options in sizes: small, medium, large, and a one size fits all.  The one your dentist will provide for you is custom fit to your mouth.

If you’re a tooth grinder, your likely to grind through them fairly quickly.  It also won’t be able tip your lower jaw into position if your TMJ requires that type of treatment.

It boils down to what your TMJ needs.  i’d at least speak with a TMJ dentist to determine the severity of your case and prescribe the correct treatment for it.  The office can help you understand the cost of treatment and you can make a decision based on that.

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.

My jaw has locked

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My jaw has locked up.  I’m trying to reach my dentist, but wondered what I can do about it in the meantime.  I’ve heard this can have something to do with TMJ.

Amanda H. – New Jersey

Amanda,

Yes, locked jaws are generally related to  TMJ.  It happens when the condyle (the head of the lower jaw) is unable to move back over the disc into its normal position.

Your jaw being locked is very uncomfortable. Use heat and/or ice packs, along with anti-inflammatories or muscle relaxers.

If that doesn’t work, it will be recommended for you to wear a splint to reposition the the disc.  You don’t want to wear the splint on a long-term basis, just enough to get it to work properly.  Otherwise, it could change your bite.

You’ll want to see someone with training in neuromuscular dentistry. It would be best to find someone with LVI training (The Las Vegas Institute).

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.

 

Dentist for headaches??

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I’ve been going to the doctor for headaches.  He’s tried several things, but I’ve gotten no permanent  relief.  He’s finally decided it’s not medical and is sending me to a dentist. Is this just his way of blowing me off, or can dentists really do something about headaches?

Kitty B. – Orlando, FL

Kitty,

Your doctor may be frustrated, but he might actually have pinpointed the problem.  There is a condition called TMJ that is known to cause persistant headaches and migraines–especially in the mornings.

I would go see a TMJ dentist and let him or her evaluate you.  They’ll be able to tell you if that is what is causing your headaches. I’m assuming that your doctor has already done a CT scan as well?

If the cause is TMJ, it can sometimes be treated with something as simple as an oral appliance.

This blog is brought to you Grosse Pointe Cosmetic Dentist Dr. Theodore Hadgis.